Chances are you’ve already heard quite a bit about the novel weight loss medication Ozempic.
News channels, social media platforms, and talk shows all glamorize the quick solution it offers. Honestly, your favorite celebrity may use it to maintain their physique.
But what is it? How does it work? Why is it suddenly so popular? Are there risks?
What is Ozempic?
Ozempic is the brand name for the active ingredient, Semaglutide. It is manufactured by Novo Nordisk, a company valued at hundreds of billions of dollars today.
The medication is an injection used once a week, ranging from 0.25 mg to 2 mg.
After its approval in late 2017, the medication hit the market in 2018 to help manage type II diabetes.
Type II diabetes is characterized as resistance to insulin; think of it as a tolerance to insulin, the pancreas produces larger amounts of it consistently to compensate for the lack of response.
Before Ozempic, a common treatment of type II diabetes was and still is a combination of oral medication(s) and insulin.
Other brands
Ozempic is often the medication that comes to mind when discussing Semaglutide because this is its first and original brand name.
Other names such as Wegovy and Rybelsus have surfaced to cause some confusion as to how these meds may be different.
Wegovy is also an injection and is prescribed specifically for weight loss. The FDA approved the use of Semaglitude for weight loss on June 4th, 2021.
Rybelsus is a tablet form of semaglutide, which is prescribed for type II diabetes in those who prefer oral routes rather than injections.
Ozempic, Wegovy, and Rybelsus may appear different through varied packaging and advertising. However, all three are manufactured by the same company; Novo Nordisk.
How does Semaglutide work?
Semaglutide lowers blood sugar in three ways
- When your blood sugar is high, it helps your pancreas produce more insulin
- It decreases the amount of sugar the liver produces and releases
- The food leaving your stomach slows down
- this is why people feel fuller for longer
Now into the science…
Producing insulin and lowering blood sugar
Semaglutide is a GLP-1, or Glucagon-Like Peptide 1, analog; meaning it was created to mimic the effects of the naturally occurring GLP-1 in the human body
An analog in biological terms is a structure that functions similarly to the original structure but has a different origin.
Glucagon stimulates the liver to convert stored glycogen into glucose, releasing glucose into the blood
GLP-1 suppresses glucagon production in the alpha cells of the pancreas
GLP-1 also stimulates beta cells to produce insulin, thus lowering blood sugar
If we add GLP-1 to the blood, the liver produces less glucose (sugar) and increases insulin production
Higher circulating insulin and lower blood sugar is the ideal treatment in most type II diabetes cases
Conversely, in individuals without type II diabetes, the medication results in steady weight loss during use
Slowing Digestion
Slowing digestion is also called gastroparesis or “slowing gastric emptying,” meaning food stays in your stomach and digestive tract longer.
Mechanisms to explain gastroparesis in Ozempic users seem to vary. However, since GLP-1 is known to regulate stomach movement and emptying, researchers hypothesize the GLP-1 analog to be the culprit.
Whatever the reason, studies are finding statistically significant data to support findings of delayed digestion in semaglutide users.
Side effects of glp-1 analogs
Gastroparesis
While gastroparesis contributes to a feeling of fullness and weight loss, there are some uncomfortable side effects that include…
- Bloating
- Nausea
- Vomiting
- Abdominal pain
- Malnutrition
- Abnormal blood sugar levels
There is a wide variety of causes of gastroparesis. While this particular symptom is receiving more media attention, it is nothing new.
Some studies estimate anywhere from 20-50% of type I and type II diabetics suffer from this due to the disease alone
Further, these symptoms can be caused by other medications such as opioids, antidepressants, or even a consistent high-fiber diet.
“Ozempic face”
Ozempic face is a slang term referencing the sagging facial skin following rapid weight loss. A supposed “hollowed appearance” around the eyes and bone structure appears during and after use.
However, it is important to consider changes in facial features that happen in any weight loss; Ozempic-related or not.
It’s more noticeable with semaglutide usage because it is a much faster change than lifestyle-related weight loss
As fat cells shrink around the face, the skin that had stretched to accommodate the extra fat may sag slightly causing the “aged look” of “Ozempic face”
As of today, there does not seem to be any significant data to support the notion that Semaglutide causes abnormal fat and muscle loss compared to lifestyle-related weight loss
Anesthesia and fasting
For those who have had a colonoscopy, you are well aware of the fasting rule before your procedure.
Anastesthiologists are finding patients on Semaglutide-products are at risk of aspiration during surgery due to cases of gastroparesis
The American Society of Anesthesiologists warns against using the medication 7 days before surgery as cases of regurgitation during surgery rise
Bezoars
A bezoar is a small, indigestible masses that develop in the digestive tract over time
In more serious cases, they can cause blockages, nausea, cramping, or pain due to the blocked tract
Large bezoars need to be moved surgically if too large, but if small enough, can instead be removed via a scope placed through the mouth
Currently, it’s assumed the gastroparesis seen in Semaglutide users causes the development of bezoars, and more often are these blockages found in medical examinations
serious side effects
While less common, the risks commercials read as the actors dance through a field of daisies are very real and should be considered
Pancreatitis, or pancreatic inflammation, has been recorded in some semaglutide users. This can be characterized by pain in the upper left or middle of the abdomen.
Kidney problems or failure are also consistent in some cases of usage of semaglutide products
Gallbladder issues, characterized by a yellowing of the skin or eyes and pain in the upper abdomen, have also been recorded during usage.
The Takeaways
Novo Nordisk manufactured Ozempic, followed by Wegovy and Rybelsus
Semaglutide is FDA-approved for both Type II Diabetes and weight loss
Semaglutide is a GLP-1 analog, mimicking the human peptide to control blood sugar, insulin, and fullness
There are several risks to taking any medication, each of which should be considered with a medical professional before trying a new prescription